Running in Place: Implications of HIV Incidence Estimates among Urban Men Who Have Sex with Men in the United States and Other Industrialized Countries
Running in Place: Implications of HIV Incidence Estimates among Urban Men Who Have Sex with Men in the United States and Other Industrialized Countries
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DOI：
10.1007/s10461-008-9509-7
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发表时间：
2009-08-01
影响因子：
4.4
通讯作者：
Mills, Thomas C.
中科院分区：
文献类型：
--
作者：
Stall, Ron;Duran, Luis;Mills, Thomas C.
试图记录男男性接触者中不断变化的艾滋病毒发病率受到普遍性和统计能力问题的影响。为了解决这些问题，本文报告了1995-2005年期间欧洲、北美和澳大利亚所有已发表的MSM发病率文献的年平均艾滋病毒发病率。符合入选标准的出版物按世界区域、抽样方法和研究年份进行编码。从这些报告中，我们计算了这些变量的平均发病率和置信区间。虽然从1995年到2005年，男男性行为者的平均发病率没有差异，但澳大利亚的艾滋病毒发病率低于北美或欧洲。我们计算出美国男男性行为者的平均发病率为2.39%，如果在男男性行为者队列中保持这一水平，那么在40岁时艾滋病毒感染率约为40%。这些推断与美国40岁以下男男性接触者的艾滋病流行率重叠。2-3%的艾滋病毒发病率将在未来几十年对男同性恋群体的健康产生不利影响。这一分析表明，应该更多地关注如何最好地设计预防干预措施，以降低男同性恋者的艾滋病毒发病率。
Attempts to document changing HIV incidence rates among MSM are compromised by issues of generalizability and statistical power. To address these issues, this paper reports annualized mean HIV incidence rates from the entire published incidence literature on MSM from Europe, North America and Australia for the period 1995-2005. Publications that met the entry criteria were coded for region of the world, sampling method and year of study. From these reports, we calculated a mean incidence rate with confidence intervals for these variables. Although no differences in mean incidence rates were found for MSM from 1995 to 2005, HIV incidence rates are lower in Australia than either North America or Europe. We calculated a mean incidence rate of 2.39% for MSM in the United States, which if sustained within a cohort of MSM, would yield HIV prevalence rate of approximately 40% at age 40. These extrapolations overlap published HIV prevalence rates for MSM younger than age 40 in the United States. HIV incidence rates in the 2-3% range will adversely affect the health of gay male communities for decades to come. This analysis suggests that greater attention should be devoted to the question of how best to design prevention interventions that will lower HIV incidence rates among gay men.